Marked differences among stakeholders in perceptions of value in healthcare are further complicating a drug development process already under unprecedented pressure to deliver more quickly, at lower cost and with less risk to patients, a new report from Quintiles has found.

For the second year running, the US-based biopharmaceutical services company has commissioned a New Health Report canvassing the opinions of key stakeholders with an increasing influence on drug development pipelines.

The findings of a survey conducted for the report by Richard Day Research suggest biopharmaceutical companies have their work cut out trying to find common ground that can release efficiencies in drug development and ultimately improve patient outcomes to everyone’s benefit.

For example, the survey of 200 biopharmaceutical executives (director level or above), 153 managed care executives (director level or above), 400 primary care physicians, 103 board-certified specialists and 1,000+ US adults diagnosed with, or being treated for, a chronic illness asked these stakeholders to define “value in healthcare” in their own words.

Among the unaided responses, 30% of the biopharmaceutical executives mentioned cost, 23% outcomes and 38% both cost and outcomes. But the corresponding figures for managed care executives were 43% (cost), 13% (outcomes) and 23% (cost and outcomes); for physicians 40% (cost), 10% (outcomes) and 19% (cost and outcomes); and for patients 30% (cost), 4% (outcomes) and 2% (cost and outcomes).

Different values

“Stakeholders have internalised the concept of value in very different ways, with

biopharma executives as the only group in which a majority includes outcomes as

part of their definition,” comments Quintiles’ New Health Report 2011.

“For patients and physicians, the process (quality of care) appears to matter as much as the outcome when it comes to value, although nearly one-third of patients do not feel they can define value.”

More encouraging was a general consensus among stakeholders that prescription medicines improve the health and well-being of patients.

Asked how valuable prescription drugs were to patients’ health and well-being, 90% of the biopharma executives polled said they were “extremely” or “very” valuable, compared with 90% of physicians, 85% of patients and 75% of managed care executives.

Once the conversation turned to actual costs and benefits, though, the responses were more ambivalent. Of the biopharma executives, 84% agreed that the money spent on prescription medicines was worth it, compared with 80% of patients, 69% of physicians and 56% of managed care executives.

Outcomes data

There was greater consensus, at least among executives and physicians, around healthcare value being about outcomes per dollar spent in providing services (outcomes here would include survival, extent of recovery, complications, recurrences, etc).

Among the biopharma executives, 76% mostly agreed with this definition, compared with 78% of managed care executives and 75% of physicians.

All the same, only 44% of biopharma executives said outcomes data were readily available for their organisation to demonstrate the value of prescription medicines. And of those managed care executives who reported having outcomes data readily available, 85% told the researchers they used measures developed and tracked by their own organisation.

In their efforts to drive cost/time efficiencies and risk reduction in clinical research, the report notes, biopharmaceutical companies work with innovators to develop a better understanding of disease biology, with payers to incorporate market access considerations into clinical development, speciality providers and partners to create and optimise predictive tools, and physicians to educate their patients about their medical conditions.

However, this “interconnectedness must be embraced as an opportunity, as open dialogue and ongoing collaboration will foster an environment from which innovative therapies will be developed”, Quintiles stresses.